Surgery – Instruments – Surgical mesh – connector – clip – clamp or band
Reexamination Certificate
1999-03-24
2001-01-23
Jackson, Gary (Department: 3731)
Surgery
Instruments
Surgical mesh, connector, clip, clamp or band
C602S044000, C602S058000
Reexamination Certificate
active
06176863
ABSTRACT:
TECHNICAL FIELD
The present invention generally relates to a surgically implantable patch for use in repairing a hernia or other wound. More particularly, the present invention relates to a hernia repair patch having an I-shaped filament to maintain the patch in a planar configuration.
BACKGROUND OF THE INVENTION
Surgically implantable mesh patches for the repair of inguinal and other abdominal wall hernias, which are intended for permanent placement within a patient's body space, have been provided and used previously. Tension free surgical repairs of hernias have been developed using synthetic mesh materials to bridge and to patch hernia defects. These repairs resulted in both a decrease in the recurrence rate as well as a decrease in the amount of a patient's post operative discomfort. Patients undergoing these more advanced procedures were able and are able to resume their normal activities sooner.
Some of these earlier techniques are somewhat complicated. Several use a plug or a locating member to fit within the hernia defect itself. Many of the earlier techniques were designed specifically for use in laparoscopic repair of hernias. Moreover, many of the prior inventions required suturing the patch to the patient's body tissue. Although these medical advances are acknowledged for their usefulness and success, there remained a need or needs for more improvements in the surgical repair of hernias.
DISCLOSURE OF INVENTION
A hernia mesh patch for use in the surgical repair of a patient's inguinal, or other abdominal wall hernias, is disclosed for permanent placement within a patient's body space. The hernia mesh patch of the invention has a top layer and a bottom layer of an inert, synthetic mesh, preferably polypropylene mesh, secured to each other with a seam. The seam is preferably formed by an ultrasonic weld that surrounds a stiffener or spring.
To serve a spring function, an implantable inert monofilament fiber, arranged in a configuration approximating an “I” shape, is welded between a top layer and a bottom layer of the hernia mesh patch to keep the hernia mesh patch expanded under tension in a planar configuration. The seam runs lengthwise over the patches and around each end, approximating an “I” shape. A border on at least one of the layers extends outward past the seam. The border preferably has slits that define tabs that fill uneven voids in the patient's tissue and fit more tightly with a patient's tissues.
Without the need for general anesthesia, nor expensive laparoscopic instrumentation, a surgeon repairs an inguinal hernia by making a small incision in the patient. The incision is approximately three centimeters long, is arranged obliquely, and is approximately two to three centimeters above the internal ring location of the inguinal hernia. Operating through the small incision, the surgeon uses a muscle splitting technique to perform a dissection deep into the patient's properitoneal space. The dissection creates a pocket in the space into which the hernia mesh patch may be inserted.
Thereafter, the surgeon uses his or her fingers to readily fold and compact the hernia mesh patch. The surgeon then directs the patch through the incision and into the patient's properitoneal space. The patch may then unfold and expand into its planar configuration to create a trampoline effect. The surgeon may place a finger partially through an opening between the top and bottom layers of the hernia mesh patch to conveniently and accurately move the hernia mesh patch into position to cover the defect in the patient's thick reinforcing lining of the patient's abdominal cavity. Thereafter, the surgeon withdraws his or her finger and secures the incision with stitches.
Soon after surgery, the patient's body reacts to the mesh of the hernia mesh patch. In a short time, the mesh becomes stuck, thereby keeping the hernia mesh patch in place. Thereafter, the patient's scar tissue grows into the mesh over a period of time, typically between thirty and sixty days, to permanently fix the hernia mesh patch in its intended position over the area where the hernia was located.
Small holes are cut through both layers of the mesh to increase friction and to minimize the sliding or migration of the hernia mesh patch once the patch is positioned. In one embodiment, spaced darts are attached to the material in one of the layers to serve as anchors for engaging the patient's tissue.
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Biggers Keith D.
Inman J. Douglas
Kugel Robert D.
Bard Asdi Inc.
Jackson Gary
Wolf Greenfield & Sacks P.C.
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